How can we get and keep great staff in home care?

Pay people more. That is what everyone seems to say. I don’t underestimate the impact of pay, but in this blog I want to explore some of the other issues that are also worth paying attention to.

An established home care organisation in London asked me to help them improve their service. One of the issues they faced was getting and retaining great staff. We looked at why.

“It’s because of the pay,” was the first reason offered. But that does not automatically explain why people apply and don’t turn up for the interview, why people leave within two weeks, and why people are appointed but then fail their probation.

We came up with a range of possible answers for these issues:

Why do people leave after two weeks? People don’t really understand what the job is, and when they start they realise it is not for them. Another possibility is that people can’t anticipate the impact that the working hours, etc. will have on their life, and leave.

Why don’t people don’t pass their probation? People don’t have the values, attitudes and skills needed to do the job, and we don’t find that out until they are working for us (so do not pass their probation)

Why do people not turn up for interview? One possibility is that we don’t stand out against the competition, so if they see something better before the interview they just don’t turn up.

We then tried to design our ideal person-centred recruitment process to address these issues.

Recruitment solution 1: The job information

The pack needs to powerfully communicate exactly what the role is so that people know what to expect and don’t leave within 2 weeks because they did not really understand what they were applying for. We want to ‘recruit for values’ and one way we explored this was to develop a one-page profile for the kind of person we wanted to appoint and asked, ‘could this be you?’. This had:

What people appreciate about you: listed the values and characteristics of the kind of person we were looking for

What is important to you: what is likely to matter to the ideal candidate for this role – for example they are a people person, it’s important to them to be on time

How we will support you: here we listed the ways that we will provide support to the successful applicants.

I don’t think that even the very best person-specification or job description can really capture what it is like to do the role. To address that, we included ‘a day in the life of a home-care worker’ as a way to describe what the role was like in practice. In the future it would be wonderful to have a video clip of this. This was not a sales pitch, it was an honest look at what the role is – the joys and some of the frustrations too.

If the ‘day in the life of’ is a way to show why this role is more satisfying than others for the same pay, we then want potential applicants to want to work for this particular home care organisation.

Recruitment solution 2: Informal meeting

Sharing the values and vision of the organisation is great, but if we are honest, many values and vision statements look the same. We wanted to have an opportunity for people to meet the organisation, and to ask questions of people doing the role already to find out more about it.

We planned a meet and greet session at the office on the first Thursday of every month. The graphic process of how home care worked here would be on the wall, and there would be a warm welcome with tea and biscuits and a chance to ask questions. You could see the ‘meet the team’ book with the one-page profiles of team members in it, and get support to do your own one-page profile if you needed it.

Recruitment solution 3: the application

As we are recruiting for values, and we want people to bring their whole selves to work, we wanted to know about what matters to them as individuals. We also wanted to make sure that people can follow instructions and complete tasks. Therefore we would ask people to bring a draft copy of their one-page profile to the interview. We provided people with a link to the SCIE resource, that helps people develop a one-page profile, and gave them a template (this could be handwritten) to bring in. This would be explained at the ‘meet and greet’ and people would be given support if they needed it to get on line and look at the programme. The application information also included the one-page profiles of the people who would be interviewing the applicants, so people had an example to look at as well.

Recruitment solution 4: Assessment centre

The shortlisted candidates would be invited to a day of assessment activities and an interview, although in the information pack it would be called ‘Workshop and interview day’ to sound less intimidating. As it is common for people not to turn up on the day we ask them to phone and confirm the day before. We would ask people to bring their one-page profiles with them and the first exercise is to this and talk about it with another candidate. The assessment centre includes activities that are as close as we can get to the actual work, for example they’re required to either dress each other or support people to eat. We would bring people from outside the organisation to help with the assessment centre. This could include volunteers eventually we want to include people who use the service or family. A couple of years ago the Skills for Care award went to an organisation that were getting people to feed each other as part of the recruitment process.

What happened

Ofcourse things don’t always go to plan. The homecare organisation was part of a bigger organisation that then went through a restructure and it was decided move forward with one-page profiles and person-centred reviews as new ways of working and although they introduced some of these idea – not as far as we had hoped.

I can see potential in such a different way of working, so I wanted to find another way of testing it out. We are now recruiting for two Community Circles Connectors, and using this process. I will blog about how it went as soon as soon as I can. Please share what you are trying and learning about better ways to recruit, and how you have resolved some of these questions.

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Hi, I'm Helen

I am developing Wellbeing Teams as a new way to support people in health and social care. Wellbeing Teams are small, neighbourhood, self-managed teams inspired by Buurtzorg. They work in partnership with our charity Community Circles. The first teams are delivering support at home to older people.

I have been immersed in the development of person-centred practices in the UK over the last twenty years. I was the Department of Health's expert advisor on person-centred approaches to the Valuing People Support and Putting People First Teams. I co-authored the first Department of Health Guidance on person-centred planning, and the 2010 guidance 'Personalisation through person-centred planning'. My PhD is on person-centred planning and organisational change and I have written over twenty books on person-centred thinking, planning, community and personalisation. I am a Fellow of the Royal Society of Arts.

I worked in health as an occupational therapist, and then in social care for over 30 years. I lead HSA, a social enterprise; am a founder member of Community Circles; and chair of the H S A Foundation. The HSA Foundation funded the start of our charity Community Circles.

HSA developed one-page profiles, person-centred reviews, and Working Together for Change. We have led the developments in support planning in health and social care. In 2016 HSA started working towards becoming a teal organisation, to use LaLoux's term. This means working as a self-managed team, bringing our whole selves to work, and seeing our purpose as evolving. I am a certified Holacracy Practitioner.

I am an AltMBA alumni and coached on the programme in 2016 and 2017.

I live in Heaton Moor with Andy and I have three daughters, Ellie, Laura and Kate, a dog, cats + hens. Although I am a black belt in karate, I now try to spend more time practicing yoga and mindfulness meditation.